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Maori Health needs

Andrew M Waa, Amber L Pearson, John L Ryks
Māori (the indigenous peoples of Aotearoa New Zealand) experience of colonisation has negatively affected access to many of the resources (e.g. income, adequate housing) that enable health and well-being. However Māori have actively responded to the challenges they have faced. With the majority of the Māori population now living in urban settings this exploratory study aimed to understand factors contributing to mortality resilience despite exposure to socio-economic adversity with reference to Māori well-being...
November 26, 2016: Health & Place
Melissa Evans, Clare Hocking, Paula Kersten
PURPOSE: This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand...
November 20, 2016: Disability and Rehabilitation
Ross Lawrenson, Chunhuan Lao, Mark Elwood, Charis Brown, Diana Sarfati, Ian Campbell
Many rural communities have poor access to health services due to a combination of distance from specialist services and a relative shortage of general practitioners. Our aims were to compare the characteristics of urban and rural women with breast cancer in New Zealand, to assess breast cancer-specific and all-cause survival using the Kaplan-Meier method and Cox proportional hazards model, and to assess whether the impact of rurality is different for Māori and New Zealand (NZ) European women. We found that rural women tended to be older and were more likely to be Māori...
October 11, 2016: International Journal of Environmental Research and Public Health
Erena Wikaire, Elana Curtis, Donna Cormack, Yannan Jiang, Louise McMillan, Rob Loto, Papaarangi Reid
BACKGROUND: Tertiary institutions are struggling to ensure equitable academic outcomes for indigenous and ethnic minority students in health professional study. This demonstrates disadvantaging of ethnic minority student groups (whereby Indigenous and ethnic minority students consistently achieve academic outcomes at a lower level when compared to non-ethnic minority students) whilst privileging non-ethnic minority students and has important implications for health workforce and health equity priorities...
October 7, 2016: BMC Medical Education
Phillipa J Malpas, Anneka Anderson, Pio Jacobs, Takawai Jacobs, Danielle Luinstra, Dolly Paul, Jim Rauwhero, Julie Wade, David Wharemate
AIM: To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. DESIGN: A kaupapa Māori consistent approach was undertaken. A systematic narrative technique was employed for the qualitative data analysis...
September 26, 2016: Palliative Medicine
Andrea M Teng, June Atkinson, George Disney, Nick Wilson, Diana Sarfati, Melissa McLeod, Tony Blakely
BACKGROUND: Cancer makes up a large and increasing proportion of excess mortality for indigenous, marginalised and socioeconomically deprived populations, and much of this inequality is preventable. This study aimed to determine which cancers give rise to changing ethnic inequalities over time. METHODS: New Zealand census data from 1981, 1986, 1991, 1996, 2001, and 2006, were all probabilistically linked to three to five subsequent years of mortality (68 million person-years) and cancer registrations (87 million person years) and weighted for linkage bias...
September 26, 2016: BMC Cancer
Laia Bécares, Polly Atatoa-Carr
BACKGROUND: A growing number of studies document the association between maternal experiences of racial discrimination and adverse children's outcomes, but our understanding of how experiences of racial discrimination are associated with pre- and post-natal maternal mental health, is limited. In addition, existent literature rarely takes into consideration racial discrimination experienced by the partner. METHODS: We analysed data from the Growing Up in New Zealand study to examine the burden of lifetime and past year experiences of racial discrimination on prenatal and postnatal mental health among Māori, Pacific, and Asian women in New Zealand (NZ), and to study the individual and joint contribution of mother's and partner's experiences of lifetime and past year racial discrimination to women's prenatal and postnatal mental health...
September 22, 2016: International Journal for Equity in Health
Lawrence Kingi, Roger Grech, Michael Lam, Ajith Dissanayake, Simon Otter
This case history describes a rare complaint - Calciphylaxis, seen in a New Zealand Maori patient undergoing renal dialysis. This condition causes non-healing tissue ulceration, typically with sepsis and is associated with a very high mortality rate. The need for vigilance among health professionals is highlighted, including the risk factors that may faciliate an early diagnosis; together with the value associated with a multi-disciplinary team approach to management.
July 5, 2016: Journal of Tissue Viability
Susan Sue Pullon, Christine Wilson, Peter Gallagher, Margot Skinner, Eileen McKinlay, Lesley Gray, Patrick McHugh
BACKGROUND: The transition from student to health practitioner at entry-to-practice is complex, requiring critical acquisition of collaborative practice skills. In rural communities where health need is multidimensional, there is potential for multiple intentional collaborative learning objectives to be met concurrently. A five-week, rurally-located, clinically-based interprofessional programme was introduced as a transition-to-practice rotation for final-year, pre-registration health professional students in the professions of dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy...
May 28, 2016: BMC Medical Education
Philip J Schluter, Annabel Ahuriri-Driscoll, Tim J Anderson, Paul Beere, Jennifer Brown, John Dalrymple-Alford, Timothy David, Andrea Davidson, Deborah A Gillon, John Hirdes, Sally Keeling, Simon Kingham, Cameron Lacey, Andrea K Menclova, Nigel Millar, Vince Mor, Hamish A Jamieson
OBJECTIVE: Since 2012, all community care recipients in New Zealand have undergone a standardised needs assessment using the Home Care International Residential Assessment Instrument (interRAI-HC). This study describes the national interRAI-HC population, assesses its data quality and evaluates its ability to be matched. METHODS: The interRAI-HC instrument elicits information on 236 questions over 20 domains; conducted by 1,800+ trained health professionals. Assessments between 1 July 2012 and 30 June 2014 are reported here...
August 2016: Australian and New Zealand Journal of Public Health
Anette Kira, Marewa Glover, Natalie Walker, Linda Bauld
INTRODUCTION: Smoking prevalence among pregnant indigenous women is disproportionately higher than for nonindigenous pregnant women. Incentives have been shown to increase retention in and the effectiveness of smoking cessation programs. To trial if this could work for indigenous women, we aimed to recruit and observe retention of Māori (New Zealand indigenous people) pregnant women that smoke into a cessation program using incentives. METHODS: A parallel group, randomized controlled feasibility trial was undertaken in New Zealand...
October 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Sandar Tin Tin, J Mark Elwood, Ross Lawrenson, Ian Campbell, Vernon Harvey, Sanjeewa Seneviratne
BACKGROUND: Patients who received private health care appear to have better survival from breast cancer compared to those who received public care. This study investigated if this applied to New Zealand women and identified factors that could explain such disparities. METHODS: This study involved all women who were diagnosed with primary breast cancer in two health regions in New Zealand, covering about 40% of the national population, between June 2000 and May 2013...
2016: PloS One
Beverley Lawton, James Stanley, Sara Filoche, Sue Garrett, Sally B Rose, Bridget Robson, C Raina Elley
OBJECTIVE: To investigate maternal and birth-related risk factors associated with infant respiratory hospitalisations in New Zealand. METHODS: A Kaupapa Māori-framed retrospective cohort analysis of public hospital maternal data linked to infant data (54,980 births 1995-2009). Primary outcome was rate of hospitalisation for respiratory disease in the first year of life. Risk variables examined included socioeconomic status (SES), age, smoking, parity, gestation, time to hospital discharge, breastfeeding and maternal ethnicity as a potential marker of differential exposure to risk factors...
March 30, 2016: Australian and New Zealand Journal of Public Health
Marewa Glover, Anette Kira, Tracey Cornell, Ces Smith
Objective Māori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Māori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited...
June 2016: Maternal and Child Health Journal
Philip J Schluter, Martin Lee
BACKGROUND: Gross and important inequities have historically existed in the oral health profiles of New Zealand children. Following the New Zealand Government's strategic oral health vision, launched in 2006, nationally collected information from 2004 to 2013 was used to analyze patterns in the prevalence of no obvious decay experience (caries-free) and mean decayed-missing-filled teeth indices over time and by community water fluoridation (CWF) and ethnic classifications in New Zealand children aged 5 years and in school year 8 (generally aged 12-13 years)...
2016: BMC Oral Health
Isaac Warbrick, Denise Wilson, Amohia Boulton
BACKGROUND: Māori (indigenous peoples of New Zealand) men have a disproportionate prevalence of lifestyle-related illnesses and are targeted for national physical activity initiatives. While physical activity impacts on physical and mental health and overall wellbeing, current approaches to health promotion often lack cultural relevance. Having better understanding and incorporating relevant cultural values and motivators into program designs could improve the success of health initiatives for indigenous and minority men...
2016: International Journal for Equity in Health
T Leigh Signal, Sarah-Jane Paine, Bronwyn Sweeney, Diane Muller, Monique Priston, Kathryn Lee, Philippa Gander, Mark Huthwaite
OBJECTIVE: To describe the prevalence of symptoms of depression and anxiety, and the level of life stress and worry in late pregnancy for Māori and non-Māori women. METHODS: In late pregnancy, women completed a questionnaire recording their prior history of mood disorders; self-reported current depressive symptoms (⩾13 on the Edinburgh Postnatal Depression Scale), current anxiety symptoms (⩾6 on the anxiety items from the Edinburgh Postnatal Depression Scale), significant life stress (⩾2 items on life stress scale) and dysfunctional worry (>12 on the Brief Measure of Worry Scale)...
January 20, 2016: Australian and New Zealand Journal of Psychiatry
Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft
In Australia, a significant number of culturally and linguistically diverse (CALD) grandparents are sole carers for their grandchildren. Available information on the impact of caring on CALD grandparents and the ability of service providers to respond to their needs is limited. Our needs-gap analysis quality improvement project aimed to uncover 'hidden issues' for CALD grandparent carers so that services can be improved. One hundred service providers, such as community and aged-care services, child and/or grandparent support services and CALD-specific services, were approached using six structured questions...
January 11, 2016: Australian Journal of Primary Health
Pauline Norris, June Tordoff, Brendon McIntosh, Kunal Laxman, Shih Yen Chang, Leanne Te Karu
BACKGROUND: Prescription charges or copayments have been shown to reduce consumption of medicines. For people living in poverty, prescription charges can prevent them from getting the medicines they need, and this can result in poorer health status. Prescription charges are low in New Zealand compared to many other countries, but those living in poverty are not exempt from fees. OBJECTIVES: The aim of this study was to explore the lived experience of people who struggle to pay prescription charges and to propose a model for how being unable to afford prescription charges might affect health...
November 11, 2015: Research in Social & Administrative Pharmacy: RSAP
Hinemoa Elder, Paula Kersten
The importance of tools for the measurement of outcomes and needs in traumatic brain injury is well recognised. The development of tools for these injuries in indigenous communities has been limited despite the well-documented disparity of brain injury. The wairua theory of traumatic brain injury (TBI) in Māori proposes that a culturally defined injury occurs in tandem with the physical injury. A cultural response is therefore indicated. This research investigates a Māori method used in the development of cultural needs assessment tool designed to further examine needs associated with the culturally determined injury and in preparation for formal validation...
2015: Behavioural Neurology
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